What happens when I am placed on the waiting list?

You will get put on the waiting list once:

  • Funding has been agreed
  • You have managed to maintain a stable weight
  • All assessments have been completed
  • The appropriate surgical procedure has been agreed with you

Group Education

You will receive a letter inviting you to Group Education on two occasions.

Currently for your safety and convenience, these sessions are virtual.  In both instances, you will be sent a link to the video sessions and asked to complete a quiz, to check your understanding of the topics covered.  After you have emailed us with your answers to the quiz questions and we have acknowledged the receipt of your answers you will move on to the next step of the pathway. 
These video sessions should take approximately 45minutes to complete, but you should take as long as you need to understand the content.
You cannot progress to the next stage of the pathway without attending both of the Group Education sessions.

Pre-assessment appointment

This is usually about four weeks before surgery and carried out by the pre-assessment nurse.

Its purpose is to check that you are clinically fit for surgery and an opportunity to ask any last minute questions. Blood tests and blood pressure are taken at this time.

Your weight will be checked to make sure you are on target – your operation will be postponed if you are gaining weight. You will be given an information booklet on your surgery and be advised on the pre-operative liver shrinkage diet.

The pre-operative liver reduction diet

Before your operation, it is important to follow a special pre-operative diet to help prepare your body for the surgery.

Many people who undergo obesity surgery have a large fatty liver, which can make the operation technically difficult. Therefore, it is necessary to follow a strict diet that is low in dietary carbohydrate and fat. This diet will encourage the body to use up glycogen stores (carbohydrate that is stored in the liver), thus helping to shrink the size of the liver. This diet should be strictly followed for a period of 2- 12 weeks prior to surgery; your specific length will depend on your surgeon’s recommendation.

It is essential you follow this diet; otherwise you are jeopardising the procedure and in most cases the surgeons will terminate the surgery.You should use this time period as an opportunity to kick-start your weight loss.. Higher weight loss prior to surgery is associated with reduced risk related to surgery.

Admission for surgery
You may be given an injection on the morning of admission to reduce the risk of developing life-threatening clots in your veins or your lungs (thromboembolism and PE) though your surgeon may choose to give it only after the operation. You may also be asked to avoid taking some of your medicines by the pre-assessment nurses.

The surgical team and the anaesthetists will see you prior to surgery. They will confirm that you are willing to undergo surgery, all preparations are complete and it is safe to proceed with your operation. They will also confirm that an appropriate facility (High Dependency Unit or specialist ward) is available for you to recover after surgery. Rarely, due to unexpected emergency admissions, the requested beds are not available – your operation will then be rescheduled for another date.

You will be taken into the theatre and general anaesthesia will be administered on the operating table.
What happens in hospital after surgery

Higher risk patients will need to stay overnight in the High Dependency Unit. A nurse will look after them on a 1:1 basis, with other duty doctors available on the unit. Otherwise you will go straight to the ward – we try to keep most of our patients on Mercers Ward.. The surgical team will visit you once a day and in case of difficulties, as and when required. You may be prescribed oral pain relief  with injections for back up.
Alternatively, you may be provided with a system that will allow you to self-administer effective pain relief safely (Patient Controlled Analgesia) – this involves setting up a pump to administer small amounts of morphine in to your vein when you press a button in your hand. The anaesthetists and the pain team may visit you to ensure that your pain control and breathing is satisfactory.

Patients with sleep apnoea will be supported with CPAP (Continuous Positive Airway Pressure). If you use a machine at home then you must bring it in with you.

Specialist bariatric equipment such as beds and chairs etc. are available to facilitate early mobilisation, which is crucial.
Your length of hospital stay will most likely be 1-3 days, depending on your surgeon’s preference and also your physical status; in general if you are a higher risk patient then you may stay in a bit longer. Below is a guide, however please note that this can vary if there are any post-operative complications:
• Gastric Bands – Day case or overnight
• Sleeve or Bypass (Roux-en-Y or Single Anastomosis) – 1-3 nights stay; may include first night in a High Dependency Unit.
You will normally be allowed to drink any fluids from the day after surgery – you should avoid sugary, fizzy drinks or drinks with high fat content.

After surgery all medication and supplements should be taken in soluble, liquid or chewable form for the first two weeks– if these forms are not available then consult your pharmacist or GP to check if your medicine can be crushed. You will be given a two week supply of your medication to go home after discharge.

You will be expected to sit up within an hour and begin mobilising soon after your operation on the day of the surgery to help prevent blood cloths.
You will be seen by the Bariatric Nurse specialist or a Specialist Bariatric Dietitian, who will give your bariatric surgery discharge instructions and contact details you need advice once you are discharged or should you experience any post-operative complications. They will review your understanding of the post-operative diet progression, supplementation, physical activity, wound care and follow-up appointments.

Post-operative diet progression
Post-operatively you will be on a liquid diet for two weeks, soft moist food for 2 weeks and then gradually progress on to a regular textured diet.
Page last updated: 12 May 2016
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